Everyone seemed happy, excited, hopeful. Ryan sighed, looking at his feet. It had been a difficult year. His surgical practice had been slow to recover following the pandemic. Countless problems with his staff, endless conflicts, and reduced income. His wife of eight years had died from complications related to COVID and asthma 2 years ago. He felt listless – and didn’t know if it was grief or depression, but overwhelm threatened to suffocate him. He couldn’t feel. His normal, characteristic appetite for fun and humor had disappeared. And time was passing, but he didn’t seem to be getting any better. In fact, he honestly seemed to be getting worse. And worse. Over the last 2 years he’d tried medications and various treatments, but his despair hadn’t budged. He’d never experienced anything like this. And he didn’t know how he could face another year of this depression and suicidal thoughts.
Friends Try to Help, But Their Help Misses Its Mark
Paul, his best friend for 17 years, tried to help by reminding him of all he had to be thankful for. It didn’t help. His wife would talk about all the things they used to do, and the hilarious scrapes he and Paul would get into. Like the time they dressed up a cadaver in black tie and stood it behind the lectern at the front of the pathology class. The raised eyebrow of the professor when he walked in.
Or the time they placed field mice in the beds in the girls’ dorm at summer camp. There had been endless shenanigans in those days.
But now, everything had changed. This dark, vacant abyss.
Depression and Suicidal Thoughts
He missed his wife terribly. They’d been a formidable team. They’d talked about everything, and putting their heads together had usually resulted in outstanding, breakthrough solutions. He felt isolated now. And overwhelmed at trying to build his practice — and his life — again.
But there was more to this than grief.
Ryan’s mother had died 6 years ago. He had grieved deeply, but grieving took place inside him while he lived his life. It hadn’t robbed him of the capacity to function like this. His doctors called this depression, but he’d had no idea depression could scoop out his very sense of humanity like this, leaving nothing but a black hole … a shell.
Ryan couldn’t help but feel he was a drain, a drag… a burden… on his sons. His depression and suicidal thoughts had to be hard for them to be around. He thought about what a relief it would be for them if he didn’t exist anymore. He contributed little or nothing to their lives these last couple years. And with all he had tried to do to get better, nothing changed.
He began to withdraw into himself and ruminate about how he might speed up his demise. And more and more he considered making it happen before New Year’s Eve.
Paul contacted him often, just to let him know he was there…and that he cared. To communicate to Ryan that he was so valuable, so needed, so appreciated. But Ryan couldn’t really absorb his friend’s intent.
Ryan felt helpless. Hopeless. With waves of despair and futility.
Life Seemed to Be Ending
He couldn’t picture life without this gaping, numb emptiness. He couldn’t form a picture of life like it used to be.
This flat, lackluster existence. Ryan knew he wasn’t “right.” He’d known it for a long time. Maybe this state of being had snuck up on him, and he didn’t recognize it at first. But, as time dragged on, he realized the light was gone and had been for awhile. What was left were depression and suicidal thoughts.
He used to enjoy basketball in the driveway, or dancing with his wife at concerts in the park. But now, he didn’t enjoy anything. He didn’t enjoy, period. Nothingness.
Paul read everything he could find to learn more about how to help someone with severe depression. He learned that trying to cheer him up didn’t help. It just communicated his inadequacy because Ryan was unable to enjoy anything. And it would likely make him feel even more isolated and misunderstood.
So Paul learned to stop doing that. He practiced just listening to Ryan, if he had an urge to talk. To communicate to him that he loved him and their friendship no matter what form it took. That Ryan didn’t need to perform.
He also read that he should not be afraid to mention suicidal thinking. That when someone is as depressed as Ryan was, thoughts of suicide were likely already going through his mind. So to shine a light on them, and to explore whether Ryan has considered various methods or has potential weapons in his possession, could actually be life saving.
So… He Did.
“Ryan, do you ever think about stopping your pain by ending your life?”
Ryan was quiet a few moments.
“Yes, depression and suicidal thoughts go through my mind every day. It occurs to me that the boys would be so much better off if they weren’t weighed down by my inertia. My gloom. The boys could go places, have fun.”
Paul listened.
“I try to tell myself that I wouldn’t want to die if I was going to get better at some point. But then, that seems so unlikely. And I wouldn’t want to live out my life like this.”
Paul took a breath.
“Ryan, I can’t know what you’re experiencing. I just can’t. But I can know what I’m experiencing…and by extension, I can guess what the boys may be experiencing. And that is how much we all love you. We love who you are. Right now. We would NOT be better off – or free to have fun – if you were gone. We’d be lost. Grief stricken. Never the same again.”
Ryan looked at Paul.
“I mean it, man. You don’t have to perform or entertain us to serve some purpose in our lives. We love YOU. And we’re going to stand by you, embrace your presence, no matter what.
Something Better than Just Another Pill
“I also want to tell you about something significant I’ve learned about. Have your doctors suggested IV ketamine treatment?”
“No.”
“It’s becoming a pretty widespread treatment now, though it was more controversial 8 or 9 years ago. Ketamine is an anesthesia medicine that’s been used safely for the last 50 years or so. But now, it’s often used off-label to treat depression and other psychiatric conditions. Plus, it can stop suicidal thoughts in a few hours. By stopping those thoughts, it can give you the freedom to work on getting better.”
“I’ve tried so many things, Paul.”
“I know, man, I know. But for a lot of people, people whose treatments with other methods haven’t been effective, this is a game changer. And they say that the action of stopping suicidal thoughts is distinct and separate from its antidepressant properties. So both of those things would be working on your frame of mind. Would you like me to send you some links about it? If you decide you’re interested in exploring it, there is a prominent psychiatrist who offers this treatment a short drive away.
“When you think about how long you’ve suffered, do you think it might be worth your time to check it out? No pressure, but I thought you had a right to this information.”
“Sure…send me the link. I’ll read it.”
IV Ketamine Therapy
With the demands of work and family, Paul didn’t talk to Ryan until the following weekend.
Ryan told him he had made an appointment with this psychiatrist, and she had encouraged him to hope. “She said she had seen people who had been severely depressed for years start improving and even achieving remission with ketamine.
“She also assured me that ketamine could stop suicidal thoughts in an afternoon, and had been lifesaving to lots of people.
“So I started my first infusion on Tuesday, then received another on Thursday. I can’t say I actually feel better at this point, but the suicidal thoughts have stopped. That in itself is an improvement.
“She also explained that ketamine does a variety of things around the brain. It’s an NMDA receptor antagonist, and builds a dense network of synapses as a result of the brain-derived-neurotrophic-factor, the BDNF.
It also works in the lateral habenula to improve my reward system, and can increase serotonin. So it actually targets my ability to enjoy. That’s a big factor. With our medical training, we can both see how all that supersedes what oral medications do.
“I’m watching for improvement, and the boys have their eyes peeled, too.”
“Wow! This is great news, man. Great news. Maybe we can meet for lunch after your session on Tuesday. I could pick you up and take you home afterwards. What do you think?”
“Ok, that might be nice. Thanks for the offer. I may be a little squirrelly for awhile until it wears off.”
“No worries, Ry. I’ll look forward to it.”
Symptoms Improve Dramatically
On Tuesday, after the infusion, Ryan noticed a lifting sensation. Almost a physical feeling in his chest, but somehow instinctively he knew it must be his sad emotions being lifted.
“Weird,” he thought.
At least it’s not my imagination, he mumbled.
He actually enjoyed lunch with Paul, for the first time in a couple years. That emptiness and numbness…could it be changing? It was a little easier to talk, to think of something to say. Hmmmm….
Even better, the compulsion to get off by himself and withdraw into silence…to avoid human contact… wasn’t so overwhelming.
A week later, Paul picked him up again, and they headed for lunch.
“So how are you today, Ry?”
Remission From Depression and Suicidal Thoughts
“I’m improving. It’s a subtle process, but unmistakeable. Hope is brewing. I can actually see I’m improving. Still no thoughts of ending my life. And that listless, futile feeling is dissipating.
I’m beginning to get glimpses of life without depression. I find myself thinking of something I want to get done, and I get up and do it. Honestly, I haven’t been able to do that in a looong time.
“And…I looked forward to seeing you today! How about that??” Ryan smiled a bright smile.
In all, Ryan received 10 infusions with dosages that increased incrementally each time. By that time, he was smiling and laughing. He felt relaxed and hopeful. He found he could enjoy things he used to enjoy…and over the coming weeks he felt better and better.
Ryan also discovered that he had the power to follow through with activities and responsibilities that used to be integral to his life, but that he’d not been able to manage for a long while. Ryan looked to the new year with confidence. And hope.
How Are You Doing?
The holidays can be a difficult time, and for some it’s a painful time. When the people around you are having fun, it can magnify how bad you feel… and make you feel isolated.
If you have been experiencing depression and suicidal thoughts, call us.
IV ketamine treatment can stop suicidal thoughts in an afternoon, and help you achieve remission from your symptoms. We’re here to help.
If you’re having suicidal thoughts or thoughts of hurting yourself, call the Suicide and Crisis Lifeline at 988 now.
And a very Happy New Year to you and your loved ones!
To the restoration of your best self,
New Year